A Unique, Innovative, Easy-to-Use Program to Improve Young Children's Attitudes About and Consumption of Fruits and Vegetables.

Getting children to eat fruits and vegetables (FV) is an important strategy for the prevention of childhood obesity. However, efforts to increase access to FV have also resulted in many of the vegetables and fruits being wasted, leaving children without the nutritional benefits and the resources not achieving their full desired impact. Multidisciplinary influences have shaped a new program for children ages 2 to 7 that can increase the desirability of and consumption of FV. The Guinea Show is easy-to-use, entertaining, and low cost and features an innovative role model. Results from field tests of The Guinea Show in preschool classrooms are included and indicate that children are more likely to try FV. Brief instructions on how to use this method are described.

Validation of the Actical Accelerometer in Multiethnic Preschoolers: The Children's Healthy Living (CHL) Program.

This study aimed to determine the validity and reliability of the Actical accelerometer for measuring physical activity (PA) in preschool children of mixed ethnicity, compared with direct observation via a modified System for Observing Fitness Instruction Time (SOFIT) protocol and proxy parental reports (PA Logs). Fifty children in Hawai'i wore wrist-mounted accelerometers for two 7-day periods with a washout period between each week. Thirty children were concurrently observed using SOFIT. Parents completed PA Logs for three days. Reliability and validity were measured by intra-class correlation coefficient and proportions of agreement concurrently. There was slight agreement (proportion of agreement: 82%; weighted Kappa=.17, P <.001) between the accelerometer and SOFIT as well as between the accelerometer and the PA Logs (proportions of agreement: 40%; weighted Kappa=0.15, P <.001). PA logs underestimated the PA levels of the children, while the Actical was found to be valid and reliable for estimating PA levels of multiethnic, mixed ethnicity preschoolers. These findings suggest that accelerometers can be objective, valid, and accurate physical activity assessment tools compared to conventional PA logs and subjective reports of activity for preschool children of mixed ethnicity.

Recruitment Strategies and Lessons Learned from the Children's Healthy Living Program Prevalence Survey.

The US Affiliated Pacific region's childhood obesity prevalence has reached epidemic proportions. To guide program and policy development, a multi-site study was initiated, in collaboration with partners from across the region, to gather comprehensive information on the regional childhood obesity prevalence. The environmental and cultural diversity of the region presented challenges to recruiting for and implementing a shared community-based, public health research program. This paper presents the strategies used to recruit families with young children (n = 5775 for children 2 - 8 years old) for obesity-related measurement across eleven jurisdictions in the US Affiliated Pacific Region. Data were generated by site teams that provided summaries of their recruitment strategies and lessons learned. Conducting this large multi-site prevalence study required considerable coordination, time and flexibility. In every location, local staff knowledgeable of the community was hired to lead recruitment, and participant compensation reflected jurisdictional appropriateness (e.g., gift cards, vouchers, or cash). Although recruitment approaches were site-specific, they were predominantly school-based or a combination of school- and community-based. Lessons learned included the importance of organization buy-in; communication, and advance planning; local travel and site peculiarities; and flexibility. Future monitoring of childhood obesity prevalence in the region should consider ways to integrate measurement activities into existing organizational infrastructures for sustainability and cost-effectiveness, while meeting programmatic (e.g. study) goals.

Pacific Tracker 2 - expert system (PacTrac2-ES) behavioural assessment and intervention tool for the Pacific Kids DASH for Health (PacDASH) study.

The Pacific Tracker (PacTrac) is a computer program designed to analyse food intakes of individuals from the Pacific Region. PacTrac's original output included servings of daily intake of food groups according to the United States Food Guide Pyramid, nutrient intake recommendations, and a comparison to other national nutrition recommendations. PacTrac was made available for public use through the Hawaii Foods website (hawaiifoods.hawaii.edu). PacTrac2 is an updated and expanded version of PacTrac that uses the United States MyPyramid/MyPlate food groups in household units of daily intake, rather than servings. In addition, the PacTrac2 includes a physical activity analysis tool which quantifies minutes of physical activities and their intensities based on energy estimates from the compendium of physical activity and research on children. An Expert System (ES) - a computerised decision tree to guide behaviour change - was developed using information on self-efficacy and stage of readiness to change, and the fruit and vegetable intake and physical activity information from PacTrac2. The ES produces reports for the child, the parent/guardian, and the child's physician with child-specific strategies, targeted behavioural information, and feedback tailored to the child. PacTrac2-ES was designed for the Pacific Kids DASH for Health (PacDASH) intervention study, conducted in the Kaiser Permanente health care system in Hawaii. The intervention is based on the child's self-efficacy and stage of readiness to change intake of fruits and vegetables and physical activity, with a goal of maintaining body weight to prevent obesity. The intervention is complemented with stage-based mailers addressing the environment for physical activity and fruit and vegetable intake and newsletters that address related behaviours (sedentary activity and a DASH eating approach). This project is the first to expand the PacTrac to contain children's foods and physical activities from the Pacific Region and to use current US MyPyramid/MyPlate food and physical activity analysis and guidance systems, and to develop and implement an Expert System for fruits, vegetables and physical activity of 5-8-year-old children. The PacTrac2-ES was used in the PacDASH study and will be used for other programs to promote healthy eating and physical activity of children in the Pacific Region.

Psychological stress in adoptive parents of special-needs children.

This article focuses on the nature and extent of parental stress among adoptive parents of special-needs children. In-depth face-to-face interviews of adoptive parents of 35 children were conducted, on average, four months postplacement (but before adoption). One-year follow-up interviews were conducted with parents of 15 (43%) of these children. Qualitative and quantitative data were collected, including parenting stress scores. Results indicated higher than average levels of stress, particularly on subscales related to parent-child dysfunctional interactions and to raising a difficult child. Increased stress levels were associated with poorer family adjustment and with higher levels of child behavior problems. Stress levels remained mostly unchanged over the year. Responses to open-ended questions identified five stress categories: child characteristics, parent-child interactions, family cohesion, parental adjustment, and adoptions service issues. Practice and research implications are discussed.